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1339 Linkside Drive TREE18-0021 04.13.2018 SCTREE REMOVAL PERMIT APPLICATION City of Atlantic Beach Community Development Department L� , yr 800 Seminole Road Atlantic Beach, FL 32233 APP, , (P) 904-247-5800 INSTRUCTIONS 1. Complete and sign this application. 2. Attach required exhibits as listed on application checklist. 3. Contact the Community Development Department if you have questions. 4. Submit the completed application and all required exhibits, along with application fees to the Permits Desk at Atlantic Beach City Hall. SITE INFORMATION I FOR INTERNAL OFFICE USE ONLY PERMIT #T PEC- I �-cy!�1 Legacy Tree $ 25.00 ❑ Single-/ Two -Family Residential $125.00 ❑ Multi -Family Residential $250.00 ❑ Commercial/ Industrial $250.00 ❑ Institutional/ Other Non -Residential $250.00 ADDRESS/ 5 3 ! L(1yk5Yb6_' I& . RE# SUBDIVISIONS L ii4 L/A/ 49/_ J� C)IVBLOCK # APPLICANT INFORMATION NAME I.% S d EMAIL LOT # ADDRESS / 3 3 CITY /�//} W% ((TATE - ZIP CODE 2233 PHONE # /� �. 2 ��� Z/� CELL # 12/oWNER ❑ LEGAL AUTHORIZED AGENT TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST PLEASE ATTACH THE FOLLOWING EXHIBITS: *Additional information may be required, depending upon circumstances unique to individual applications ❑ EXHIBIT A (Option 1) -PROOF OF OWNERSHIP: Copy of Warranty Deed that verifies record of owner (Clerk of Courts) ❑ EXHIBIT A (Option 2) - LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner ❑ EXHIBIT B- TREE INVENTORY and TREE PROTECTION PLAN ❑ EXHIBIT C- TREE MITIGATION WORKSHEET ❑ EXHIBIT D -TREE MITIGATION PLAN SITE PREPARATION CHECKLIST PLEASE PREPARE YOUR SITE AS FOLLOWS: ❑ Mark all trees identified for removal with RED or ORANGE flagging, paint or tape ❑ Mark all trees identified for preservation with BLUE or GREEN flagging, pain or tape ❑ Mark property corners with stakes or paint ❑ Barricade all trees to be preserved on the property at the dripline I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. I AGREE TO COMPLY WITH ALL PROVISIONS OF CHAPTER 23 (PROTECTION OF TREES AND NATURAL VEGETATION) AND ALL OTHER APPLICABLE CODES AND ORDINANCES OF THE CITY OF ATLANTIC BEACH. P1114-rc6W_ 1-2-20 (6 SIGNATUR F APPLICANT PRINT OR TYPE NAME DATE 02 TREE REMOVAL PERMITAPPLICATIONO3.01.2018 EXHIBIT B: TREE INVENTORY and PROTECTION PLAN City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 (P) 904-247-5800 FOR INTERNAL OFFICE USE ONLY PERMIT # i EXHIBIT C: TREE MITIGATION WORKSHEET S , City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, FL 32233 %JS;1,r (P) 904-247-5800 List the species and diameter at breast height (dbh) of all trees identified on EXHIBIT B FOR INTERNAL OFFICE USE ONLY PERMIT # rd2L-O'--' I ID DBH SPECIES removing preserving replacing COMMENTS (for use by City Staff 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 02 TREE REMOVAL - EXHIBIT C. Tree Mitigation Worksheet 03.01.2018 Date Paid: Monday, April 09, 2018 Paid By: WALSH MARGIT F TRUST Cashier: CB Pay Method: CREDIT CARD 009388 Printed: Monday, April 09, 2018 4:42 PM 1 of 1 4: 7M,KiT